Background: Pneumonia shows higher rates of morbidity and in elderly and compromised individuals. Poor oral health been suggested to be a significant risk factor for the disease, though little is known about acquisition of pathogens that could cause bacterial pneumonia. We investigated the prevalence of respiratory pathogens harbored in the oral cavity of independent elderly.
Materials and Methods: The study cohort consisted of 110 dwelling, independent elderly. Dental examinations conducted by 5 dentists, and information regarding oral health was collected by questionnaire. 12 species of opportunistic pathogens were detected in saliva and identified.
Results: Polymerase chain reaction results revealed opportunistic in 67.3% of the participants, with Klebsiella pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Serratia marcescens, and Candida spp. isolated from 4, 38, 17, 3, and 38 participants, respectively. Age was significantly lower in participants harboring H. influenzae and higher in participants with Candida albicans. 82 of the participants received routine dental prophylaxis and showed a significantly lower rate of S. aureus colonization while the frequency of dental prophylaxis had no relationship with the colonization of S. aureus.
Conclusion: Our findings suggested that elderly individuals who routine dental prophylaxis prevent oral colonization by S. aureus.

Retention of Natural Dentition and its Impact on Systemic Health: A Cross-sectional Study

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Mohammed Jafer, James Lalumandier

Background: Systemic health and mortality have been shown to be affected by oral disease, in the elderly. The purpose of this study was to examine the effects of teeth retention on longevity.
Methods: About 300 randomly chosen patient charts from the Case Western Reserve University, School of Dental Medicine, were used to obtain data on age, number of teeth present, gender, race, insurance, smoking, alcohol consumption, type of diabetes, and cardiovascular disease (CVD). A descriptive test was run to assess the distribution of demographics, systemic health, and number of teeth present. Analytic tests included bivariate and multivariate regression analysis. Pearson's correlation test investigated any association between the dependent variable, age and independent variable, number of teeth. Linear regression investigated any relationship between age and number of teeth adjusting for gender, race/ethnicity, dental insurance coverage, smoking, alcohol, diabetes, and CVD.
Results: Study sample's average age was 73.7 ± 6.8 years, with
.3% Whites and 42.3% African-Americans, and the average number of teeth present was 17.5 ± 9.9. There was a weak negative correlation with the number of teeth and age (r = −0.23, P < 0.01). The regression model predicted that for every tooth retained, age was reduced by 0.23 years. The prevalence of CVD was 69%, diabetes was 23.8%, smoking was 7.1%, and alcohol consumption was 28.3%.
Conclusion: Mortality and tooth retention, in the elderly, are both negatively correlated with age. Smoking, in the elderly, also has a negative correlation with age.

Background: Implant-supported fixed prosthodontics is a successful treatment option for oral rehabilitation. The increased incidence of mucositis and peri-implantitis may, however, compromise the longevity of such strategy. Hygiene maintenance of the prosthetic appliance is essential for long-term success of osseointegrated implants, but unfortunately, oral hygiene has been a concern that has unaccompanied the evolution of this type of restorative approach. The aim of this study was to evaluate hygiene quality of the prosthesis and the soft tissues around implants by removing the appliance for assessment.
Materials and Methods: A total of 48 patients were included in the study. Their appliances were removed for examination, assessment, and debridement. The patients were instructed to performing hygiene methods using appropriate cleaning devices. They were reevaluated after 6 months.
Results: The G-test revealed that With the implementation of the hygiene measures provided, the patients reported differences in cleaning methods used (p < 0.001) and G test revealed significant hygiene changes in the prosthetic appliance (p = 0.024) were also observed. The data showed that cleaning was not affected by education level, but by the preference for quicker cleaning strategies that required little dedication.
Conclusions : Biofilm removal is a key factor for peri-implant health though hygiene quality remained far below acceptable standards, so that biofilm, calculus pseudomembranes were present in large quantities even after hygiene instructions.

Background: Poly-methyl-methacrylate (PMMA) and microwaveable acrylic resin are used for complete denture and removable partial denture services. This study was conducted to comparatively evaluate dimensional changes in microwave processed acrylic resin and in conventional heat polymerized resin cured by water bath and microwave energy.
Materials and Methods: A total of 30 maxillary denture bases (3 mm thick) were made on cast in our study. These samples were demarcated into 3 groups. Group 1: Control, conventional heat cure PMMA cured by water bath method; Group 2 denotes conventional heat cure PMMA cured by microwave energy (500 W for 3 min); Group 3 denotes microwave acrylic resin cured by microwave energy (500 W for 3 min). After polymerization of test samples, the base/cast sets were cut transversally in the posterior palatal seal area. The measurements were made at the right marginal limit, left marginal limit, right ridge crest, left ridge crest, and the palatal midline. Stereomicroscope used to see the gaps between the casts and denture base. The data were collected and statistically analyzed.
Results: The highest dimensional inaccuracies were seen in conventional heat cure PMMA samples cured by microwave energy (500 W for 3 min), and lowest dimensional changes were seen with the microwaveable acrylic resin samples cured by microwave energy (500 W for 3 min).
Conclusion: Within the limitations of this study, it can be concluded that the highest dimensional stability is seen in microwaveable acrylic resin cured by microwave energy (500 W for 3 min) and lowest dimensional stability in conventional heat cure PMMA samples cured by microwave energy (500 W for
min).

Background: The location of neutral zone in relation to crest of ridge varies from individual to individual depending on the duration of edentulousness. The aim of this study was to determine and to compare the position of neutral zone in relation to crest of mandibular residual alveolar ridge with different duration of edentulousness. Materials and Methods: A total of 60 completely edentulous subjects were selected as subject for the study and were divided into three groups (20 in each group), depending on their duration of edentulousness - Group I: Edentulous for 6 months to 2 years, Group II: Edentulous for 2-5 years, and Group III: Edentulous for more than 5 years. Neutral zone was functionally recorded using impression compound at the predetermined vertical dimension of occlusion. Two different gauge wires were adapted and stabilized on the crest of residual alveolar ridge of mandibular cast and the center of neutral zone record rim. Occlusal radiographs were taken of each cast with the neutral zone record rim. Radiographs were studied for the buccolingual relation of the neutral zone and the crest of residual alveolar ridge, depicted by different gauge wires, in anterior, premolar and molar region. The data obtained was subjected to statistical analysis using the Kruskal-Wallis H-test. Results: Mean lingual shift of neutral zone with respect to center of crest of the alveolar ridge in mandibular right molar region is
−0.8, −2.05, and −3.60 mm for Groups I, II, and III, respectively. The mean lingual shift of neutral zone with respect to center of crest of the alveolar ridge in mandibular left molar region is −0.9, −1.90 mm, and −3.30 mm for Groups I, II, and III, respectively. Mean labial shift of neutral zone with respect to center of crest of the alveolar ridge in mandibular anterior region is 1.95, 2.95, and 4.65 mm for Groups I, II, and III, respectively.
Conclusion: With increase in duration of edentulousness, there is a more lingual positioning of neutral zone in relation to crest of residual alveolar ridge in mandibular molar regions, more labial positioning of the neutral zone with respect to crest of the residual alveolar ridge in mandibular anterior region.

Background: The search for soft liners has narrowed down to
polymers. The guiding principle being that polymers, though
all have a characteristic property called glass transition temperature. Much controversy exists as to whether these materials are temporary or permanent. Because currently available materials do not meet all of the essential requirements for the ideal material, they are generally considered to be temporary expedients for the immediate solution of specific denture problems.
Materials and Methods: An in vitro study was carried out to the effect of surface treatment on the bond strength of soft liners. Poly methyl metha acrylate specimens were prepared and placed under four categories: (1) Control, (2) sandblasted with μ aluminum oxide particles, (3) sandblasted with 150 μ aluminum oxide particles, and (4) sandblasted with 250 μ aluminum oxide particles.
Results: The soft liners used are Molloplast-B (Heat polymerizing), VLC soft reline material (Light polymerizing), and GC soft liner (Auto polymerizing). All the liners showed decrease in tensile strength and an increase in shear bond strength after sandblasting. There is no significant difference in bond strength when treated with different particle sizes.
Conclusion: Soft lining materials were applied to these surfaces and tensile and shear bond strength tests were performed. The results obtained were analyzed using a one-way analysis of variance. Tensile bond strength showed a decreased value after sandblasting, regardless of the material. Shear bond strength showed an increased value after sandblasting regardless of the material. No significant difference in the bond strength when treated with different particle sizes of aluminum oxide.

Background : Complete removal of calculus is an integral part of achieving a biologically acceptable tooth surface in the treatment of periodontitis. An ideal instrument should enable the removal of all superfluous substances from the root surface, without causing any iatrogenic effect. This study was conducted to compare the efficacy in calculus removal by hand instrument, ultrasonic scaler and hand instrumentation combined with diode laser on the root surface as well as to compare the iatrogenic effects caused by these instruments. To compare the efficacy of calculus removal as well as to compare the roughness and loss of tooth substance caused after instrumentation with: (1) Hand instrument, (2) Ultrasonic scaler, and (3) Hand instrument + Diode laser application.
Materials and Methods : A total of 30 extracted non-carious non-restored human teeth with a history of periodontal disease were randomly divided into three groups of 10 teeth each and subjected to scaling and root planing with the assigned instrument. Scanning electron micrographs were taken and interpreted by a blind investigator, the indices used for this study were: Remaining calculus index, loss of tooth substance index (LTSI), and roughness LTSI. The data obtained were analyzed using Kruskal-Wallis test. Results: No statistically significant differences were found between the three groups with respect to the efficacy of calculus removal and the iatrogenic effects caused by the instruments. However, the efficacy of ultrasonic scaler was marginally better, whereas the roughness caused after laser application was more when compared with the other groups.
Conclusion: The results of this study show that all three instruments could be used for routine debridement of the root surfaces. Ultrasonic scalers were found to be more efficient than hand scalers. The result also suggests that the diode laser may be routinely used as an adjunct to scaling and root planing as the surface alterations caused were minimal.

A Comparative Study to Test the Efficacy of Two Antimicrobial Agents (10% Povidone-Iodine and Chlorhexidine Varnish) in the Prevention of Early Childhood Caries

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Ajay Narayan, S Anandraj

Background: To determine the antimicrobial efficacy of 10% Povidone-iodine (PI) and Chlorhexidine (CHX) varnish against Streptococcus mutans and the role of antimicrobial therapy in the prevention of early childhood caries (ECC).
Materials and Methods: A total of 30 children (3-6 years) with ECC reporting to the Department of Pedodontics, KVG Dental College and Hospital, Sullia for treatment were selected as a part of this study. The children were divided into two groups by block randomization. Following full mouth rehabilitation, one group had CHX varnish, Cervitec plus applied to their dentition and to the other group 0.2 ml of 10% PI was applied. Plaque and saliva samples were taken at baseline and at 30, 60, and 90 days following application of 10% PI and CHX varnish, and the presence of S. mutans was evaluated using Dentocult SM strip mutans. The results were evaluated using the manufacturer's chart.
Results: There was a statistically significant reduction in the S. mutans count in plaque and saliva following application of 10% PI and CHX varnish for a period of 30, 60 and 90 days. The S. mutans count was <104 CFU/ml in both the groups at 30, 60 and 90 days. However, no significant difference in the efficacy of 10% PI and CHX varnish was observed.
Conclusion: The results showed that there was a statistically significant reduction in the S. mutans count following application of 10% PI and CHX varnish for a period of 30, 60 and 90 days. No significant difference between the efficacy of 10% PI and CHX varnish was observed.

Background: This study compares the gingival papillary in areas restored with external hexagon and Morse taper implants and in healthy natural dentition. The distance from the bone crest (BC) to the contact point (CP) and the distance from the implant platform to the axial wall of the adjacent tooth influenced the papillary extension.
Materials and Methods: Jemt's index (1997) was used to the gingival papillae in 4 height levels: 0 - absent papilla; - papilla occupies less than half the distance from its base to the CP; 2 - papilla occupies more than half this distance but not the entire interproximal space; 3 - interproximal space completely occupied. The sample consisted of 27 proximal areas between natural teeth, 25 proximal areas to external hexagons, and proximal areas to Morse taper. Patients were clinically evaluated to assess presence - total or partial - or absence of the gingival papilla. Radiographies were taken with the adaptation of metallic millimetric meshes for the measurements.
Results: Regarding papillary height scores, no significant difference observed between groups (P > 0.05).
Conclusion: Group 3 - rehabilitated with Morse taper implants - had better index of papillary fill and the larger the distance between the to the BC, the smaller the papillary score. Further research with larger sample size is of paramount importance.